Page 11 - Anaphylaxis in Schools & Other Settings, 3rd Edition
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If an allergic person expresses any concern that a reaction might be starting, the person should always be taken seriously. When a reaction begins, it is important to respond immediately, following instructions in the person’s Anaphylaxis Emergency Plan. (See Appendix D.) The cause of the reaction can be investigated later. The most dangerous symptoms of an allergic reaction involve breathing difficulties caused by swelling of the airways (including a severe asthma attack in those who have asthma) or a drop in blood pressure indicated by dizziness, lightheadedness, feeling faint or weak, or passing out. Both can lead to death if untreated.
What triggers anaphylaxis?
Although many substances have the potential to cause anaphylaxis, the most common triggers are foods and insect stings (e.g. yellow jackets, hornets, wasps, honey bees). In Canada, the most common food allergens that cause anaphylaxis are:
Peanut
Tree nuts (almonds, Brazil nuts, cashews, hazelnuts, macadamia nuts, pecans, pine nuts, pistachios, walnuts)
Milk
Egg
Sesame
Soy
Wheat Seafood
Fish, e.g. trout, salmon Shellfish
- Crustaceans, e.g. lobster, shrimp, crab
- Molluscs, e.g. scallops, clams, oysters, mussels Mustard
Health Canada requires these ‘priority allergens’ to always be identified on food labels by their common names.
Medications and exposure to natural rubber latex can also cause potentially life-threatening allergic reactions. A less common cause of anaphylaxis is exercise, which in some individuals can be triggered by the prior ingestion of a specific food which is not normally a problem. In some cases of anaphylaxis, the cause is unknown (‘idiopathic’).
How is a person identified as being at risk for anaphylaxis?
Family doctors and emergency physicians are most often the first healthcare professionals to identify a person who has experienced an allergic reaction. They play an important role in discussing anaphylaxis management with individuals (e.g. allergen avoidance strategies), prescribing an epinephrine auto- injector, and referring them to an allergist for evaluation. People thought to be at risk of life-threatening allergic reactions should be evaluated by an allergist.
Note: For regulatory purposes, Health Canada uses the following terms to describe seafood: fish (e.g. trout, salmon), shellfish (e.g. scallops, clams) and crustaceans (e.g. lobster, shrimp). Health Canada also includes sulphites (a food additive) as a priority allergen.
Anaphylaxis in Schools & Other Settings
Copyright © 2005-2015 Canadian Society of Allergy and Clinical Immunology
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Consensus Statement
